Course catalogue

This course provides a brief history and overview of Medicare and Medicaid. It describes government organizations that regulate and administer this program. This course also discusses Medicare reimbursement. In addition, it highlights recent changes in the law affecting Medicare managed care contracting. This course also identifies the rights and responsibilities of Medicare enrollees. It also provides an overview of the Medicare Part D pharmacy benefit and points out some successes and failures of Medicaid managed care.

Learning Objectives

After completing this course, you will be able to:

• Provide an overview of Medicare and its history
• Recognize how the Centers for Medicare and Medicaid Services (CMS), the Federal Trade Commission (FTC), the Internal Revenue Service (IRS), the Office of the Inspector General (OIG), the Department of Justice (DOJ), the Securities and Exchange Commission (SEC), and the U.S. Public Health Service administer and regulate Medicare
• Define the Inpatient Prospective Payment System
• Recognize the Outpatient Medicare Prospective Payment System
• Recognize how Medicare provides payment to physicians
• Recognize relevant legislative changes affecting Medicare managed care
• Recognize demonstration projects
• Recognize examples of these projects
• Identify key elements of ABNs
• Identify the rights and responsibilities of Medicare enrollees
• Recognize the features of Medicare Part D
• Identify how healthcare providers are paid under Medicaid
• Recognize successes and failures of Medicaid managed care

Strong leadership is built on effective communication, and impactful presentations are an essential tool for influencing, informing, and inspiring others. Inspired by the clear, audience-focused communication principles championed by Jill Geisler, this course provides a practical framework for creating presentations that connect with audiences and support confident leadership. Participants will learn how to analyze audience needs, organize ideas with clarity, use compelling and concise language, and tailor presentations for a variety of professional settings. The course also explores the strategic use of visual aids, storytelling techniques, and the widely recognized 10-20-30 Rule to improve engagement and effectiveness. Through practical examples and actionable strategies, learners will build the confidence and communication skills needed to deliver presentations that leave a lasting impression and strengthen leadership presence.

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This course highlights the various types of health insurance that your patients may present at registration. We’ll review the fundamentals of Medicare, Medicaid, and third-party liability plans along with the differences in commercial and managed care plans. You’ll learn how verifying a patient’s insurance eligibility and benefits affect the coordination of benefits process, which determines the primary payer and secondary payer on a claim.

Learning Objectives

After completing this course, you will be able to:

• Recognize the basic features of Medicare and Medicaid, commercial insurance versus managed care, and third-party liability plans.
• Learn how to perform insurance verifications and authorizations.
• Identify the process of coordinating benefits when patients have multiple insurance plans.

This course presents a big picture overview of the evolution of healthcare services delivery and payment. It highlights the healthcare transformations including the shift from volume to value, quality, payment satisfaction, competition on costs and the evolution of the payment system. Attention is given to the changing roles of managers in healthcare finance. 

Currently making up almost 20 percent of the nation’s gross domestic product, healthcare in the U.S. will be a significant factor in the national economy for the foreseeable future. This section will discuss the following topics as they relate to the big picture of healthcare.

Learning Objectives

In this course, we will address the basic billing rules for major health plans, including an overview of basic billing features and benefits, types of billing rules, and minor claim payers and plans.

Learning Objectives

After completing this course, you will be able to:

• Recognize the basic features of major government-funded health plans.
• Identify the basic features of other health plans including commercial plans and smaller government-funded plans.

How are health systems thinking about artificial intelligence (AI)? Where are health systems investing and what support do they need from vendors to capitalize on the efficiencies of AI? Based on feedback from over 225 health system health system executives, this comprehensive study provides a holistic view of health system challenges surrounding artificial intelligence. This report includes a detailed look at health system readiness for AI, niche areas of opportunity for vendors to bring AI knowledge to health systems among others.

Key Benefits

Key benefits of the report include:

• Understanding of top sources of margin pressure on hospitals and health systems
• Insights into the strategies being implemented and where opportunities are for solution providers
• CFO personas and how they are involved in purchasing decisions

*Due to the report being a digital download being immediately accessible upon purchasing, no refunds will be issued for any circumstances.

*Companies currently Peer Reviewed by HFMA will receive a copy of the study at no charge.

Jointly provided by HFMA and PIM - Postgraduate Institute for Medicine, this program offers ONLY the study materials. The assessment (CME post-test) is taken via PIM’s CME University. This activity has been designed to meet the CME educational needs of physicians, pharmacists, registered nurses, dentists, and other healthcare providers. HFMA Business of Health Care® for CME is a comprehensive online program that presents an overview of today’s healthcare environment and highlights the shift in healthcare service delivery and evolving payment models. If you wish to receive acknowledgment and continuing medical education credits for completing this activity, please complete the post-test (assessment) and evaluation on www.cmeuniversity.com.

Understand how your decisions impact the delivery of quality care with HFMA's Business of Health Care® online program. No matter your role in healthcare, this course is designed to provide essential context around the business fundamentals of pricing, cost, revenue, payment and delivery models.

HFMA Business of Health Care® for CME

• Jointly provided by Postgraduate Institute for Medicine and Healthcare Financial Management Association
• Release date: April 1, 2019
• Expiration date: April 30, 2026
• Estimated time to complete activity: 13.5 hours

Target Audience

This activity has been designed to meet the educational needs of physicians, pharmacists, registered nurses, dentists and other healthcare providers.

Educational Objectives

After completing this activity, the participant should be better able to:

• Identify the current trends of healthcare delivery models in the US and determine the impact of healthcare reform on healthcare delivery and payment.
• Determine an organization’s financial health using key financial statements and financial analysis tools
• Describe how financial strategic planning influences budgeting, cost allocation, and pricing for healthcare services
• Identify all components of the revenue cycle including patient engagement, billing, and collections as they relate to hospitals, physicians and payers
• Identify new payment models and describe the trend of population health in future healthcare delivery models

Original Delivery Date: Tuesday, June 16th, 2026, 2:00 - 3:00 PM CST

Reactive documentation costs health systems millions and leaves the clinical and revenue cycle teams on the defensive, chasing errors and missing information instead of focusing on patient care and financial stability! Imagine a different reality. What if your hospital system could get ahead of the curve, capturing accurate and complete documentation at the point of care? This is proactive documentation – and it's the key to unlocking significant revenue and empowering your teams. This webinar will equip you with actionable strategies to drive and protect your health system’s revenue through the power of proactive documentation. Learn how to shift from a reactive, error-prone approach to a proactive, accurate, and financially sound strategy.

Original Live Webinar Date: June 3, 2025

• Describe the financial benefits of proactive documentation
• Describe actionable strategies to implement a solid proactive methodology in your organization
• Share insights into the technologies that enable proactive documentation success
• Summarize key metrics to track the impact of your proactive initiatives

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